Top Five List, Family Medicine
- Don’t do imaging for low-back pain in the first six weeks unless certain red flags are present.
- Don’t routinely prescribe antibiotics for acute mild to moderate sinus inflammation unless certain symptoms last at least seven days or improve, then worsen.
- Don’t order annual ECGs or other cardiac screening for low-risk patients with no symptoms.
- Don’t perform Pap smears on patients younger than 21 years of age or in women who had a hysterectomy for benign disease.
- Don’t use DEXA screening for osteoporosis in women under age 65 years or men under 70 with no risk factors.
Top Five List, Internal Medicine
The list included the same recommendations on low-back pain, cardiac screening and DEXA screening, as well as:
- Don’t obtain blood chemistry panels or urinalyses for screening in healthy adults with no symptoms.
- Use only generic statins when initiating lipid-lowering drug therapy.
Top Five List, Pediatrics
- Don’t prescribe antibiotics for a sore throat unless the patient tests positive for strep.
- Don’t obtain diagnostic images for minor head injuries without loss of consciousness or other risk factors.
- Don’t refer patients to a specialist for fluid behind the eardrum in the middle ear early on unless there are other red flags (such as learning problems or structural problems).
- Advise patients not to use cough and cold medicines.
- Use inhaled corticosteroids to control asthma appropriately.